Effectiveness of Interventions to Improve the Anticholinergic Prescribing Practice in Older Adults: A Systematic Review
Background: Pharmacotherapy in older adults is one of the most challenging aspects of patient care. Older people are prone to drug-related problems such as adverse effects, ineffectiveness, underdosage, overdosage, and drug interactions. Anticholinergic medications are associated with poor outcomes...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/3/714 |
| _version_ | 1797486930761351168 |
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| author | Mohammed S. Salahudeen Adel Alfahmi Anam Farooq Mehnaz Akhtar Sana Ajaz Saud Alotaibi Manal Faiz Sheraz Ali |
| author_facet | Mohammed S. Salahudeen Adel Alfahmi Anam Farooq Mehnaz Akhtar Sana Ajaz Saud Alotaibi Manal Faiz Sheraz Ali |
| author_sort | Mohammed S. Salahudeen |
| collection | DOAJ |
| description | Background: Pharmacotherapy in older adults is one of the most challenging aspects of patient care. Older people are prone to drug-related problems such as adverse effects, ineffectiveness, underdosage, overdosage, and drug interactions. Anticholinergic medications are associated with poor outcomes in older patients, and there is no specific intervention strategy for reducing drug burden from anticholinergic activity medications. Little is known about the effectiveness of current interventions that may likely improve the anticholinergic prescribing practice in older adults. Aims: This review seeks to document all types of interventions aiming to reduce anticholinergic prescribing among older adults and assess the current evidence and quality of existing single and combined interventions. Methods: We systematically searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINAHL, and PsycINFO from January 1990 to August 2021. Only studies that examined the effect of interventions in older people focused on improving compliance with anticholinergic prescribing guidelines with quantifiable data were included. The primary outcome of interest was to find the effectiveness of interventions that enhance the anticholinergic prescribing practice in older adults. Results: We screened 3168 records and ended up in 23 studies that met the inclusion criteria. We found only single-component interventions to reduce anticholinergic prescribing errors in older people. Pharmacists implemented interventions without collaboration in nearly half of the studies (<i>n</i> = 11). Medication review (43%) and education provision (26%) to healthcare practitioners were the most common interventions. Sixteen studies (70%) reported significant reductions in anticholinergic prescribing errors, whereas seven studies (30%) showed no significant effect. Conclusion: This systematic review suggests that healthcare practitioner-oriented interventions have the potential to reduce the occurrence of anticholinergic prescribing errors in older people. Interventions were primarily effective in reducing the burden of anticholinergic medications and assisting with deprescribing anticholinergic medications in older adults. |
| first_indexed | 2024-03-09T23:41:19Z |
| format | Article |
| id | doaj.art-dbf3ec44112241c49479db28f885622c |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T23:41:19Z |
| publishDate | 2022-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-dbf3ec44112241c49479db28f885622c2023-11-23T16:52:52ZengMDPI AGJournal of Clinical Medicine2077-03832022-01-0111371410.3390/jcm11030714Effectiveness of Interventions to Improve the Anticholinergic Prescribing Practice in Older Adults: A Systematic ReviewMohammed S. Salahudeen0Adel Alfahmi1Anam Farooq2Mehnaz Akhtar3Sana Ajaz4Saud Alotaibi5Manal Faiz6Sheraz Ali7School of Pharmacy and Pharmacology, University of Tasmania, Hobart 7001, AustraliaSchool of Pharmacy and Pharmacology, University of Tasmania, Hobart 7001, AustraliaPharmaceutical Care Department, Dr Sulaiman Al-Habib Hospital, Riyadh 12214, Saudi ArabiaShifa College of Pharmaceutical Sciences, Shifa Tmaeer-e-Millat University, Islamabad 44000, PakistanShifa College of Pharmaceutical Sciences, Shifa Tmaeer-e-Millat University, Islamabad 44000, PakistanPharmaceutical Care Services, King Saud Medical City, Ministry of Health, Riyadh 12746, Saudi ArabiaAzra Naheed Medical College, Superior University, Lahore 55150, PakistanSchool of Pharmacy and Pharmacology, University of Tasmania, Hobart 7001, AustraliaBackground: Pharmacotherapy in older adults is one of the most challenging aspects of patient care. Older people are prone to drug-related problems such as adverse effects, ineffectiveness, underdosage, overdosage, and drug interactions. Anticholinergic medications are associated with poor outcomes in older patients, and there is no specific intervention strategy for reducing drug burden from anticholinergic activity medications. Little is known about the effectiveness of current interventions that may likely improve the anticholinergic prescribing practice in older adults. Aims: This review seeks to document all types of interventions aiming to reduce anticholinergic prescribing among older adults and assess the current evidence and quality of existing single and combined interventions. Methods: We systematically searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINAHL, and PsycINFO from January 1990 to August 2021. Only studies that examined the effect of interventions in older people focused on improving compliance with anticholinergic prescribing guidelines with quantifiable data were included. The primary outcome of interest was to find the effectiveness of interventions that enhance the anticholinergic prescribing practice in older adults. Results: We screened 3168 records and ended up in 23 studies that met the inclusion criteria. We found only single-component interventions to reduce anticholinergic prescribing errors in older people. Pharmacists implemented interventions without collaboration in nearly half of the studies (<i>n</i> = 11). Medication review (43%) and education provision (26%) to healthcare practitioners were the most common interventions. Sixteen studies (70%) reported significant reductions in anticholinergic prescribing errors, whereas seven studies (30%) showed no significant effect. Conclusion: This systematic review suggests that healthcare practitioner-oriented interventions have the potential to reduce the occurrence of anticholinergic prescribing errors in older people. Interventions were primarily effective in reducing the burden of anticholinergic medications and assisting with deprescribing anticholinergic medications in older adults.https://www.mdpi.com/2077-0383/11/3/714anticholinergicsinterventionprescribingolder people |
| spellingShingle | Mohammed S. Salahudeen Adel Alfahmi Anam Farooq Mehnaz Akhtar Sana Ajaz Saud Alotaibi Manal Faiz Sheraz Ali Effectiveness of Interventions to Improve the Anticholinergic Prescribing Practice in Older Adults: A Systematic Review Journal of Clinical Medicine anticholinergics intervention prescribing older people |
| title | Effectiveness of Interventions to Improve the Anticholinergic Prescribing Practice in Older Adults: A Systematic Review |
| title_full | Effectiveness of Interventions to Improve the Anticholinergic Prescribing Practice in Older Adults: A Systematic Review |
| title_fullStr | Effectiveness of Interventions to Improve the Anticholinergic Prescribing Practice in Older Adults: A Systematic Review |
| title_full_unstemmed | Effectiveness of Interventions to Improve the Anticholinergic Prescribing Practice in Older Adults: A Systematic Review |
| title_short | Effectiveness of Interventions to Improve the Anticholinergic Prescribing Practice in Older Adults: A Systematic Review |
| title_sort | effectiveness of interventions to improve the anticholinergic prescribing practice in older adults a systematic review |
| topic | anticholinergics intervention prescribing older people |
| url | https://www.mdpi.com/2077-0383/11/3/714 |
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